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Boys have better short-term and long-term survival rates after intensive care admissions than girls

E Johansson Frigyesi1, P Andersson2,3, A Frigyesi2,3

  • 1Department of Paediatrics, Helsingborg Hospital, Helsingborg, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|August 24, 2017
PubMed

Insights

Boys exhibit better survival rates in pediatric intensive care than girls, irrespective of care intensity. This survival advantage is most pronounced in infants and children with respiratory issues or seizures.

Area of Science:

  • Pediatric Critical Care Medicine
  • Biostatistics
  • Epidemiology

Background:

  • Understanding gender-specific outcomes in pediatric intensive care is crucial for optimizing treatment strategies.
  • Previous research has yielded mixed results regarding gender differences in pediatric intensive care unit (PICU) mortality.

Purpose of the Study:

  • To investigate potential gender disparities in morbidity-adjusted mortality among pediatric intensive care admissions.
  • To analyze survival rates and associated factors in relation to gender in critically ill children.

Main Methods:

  • Analysis of a nationwide cohort of 21,972 pediatric intensive care admissions in Sweden (2008-2015).
  • Utilized Cox regression to assess morbidity-adjusted survival, with gender as a key variable.
  • Employed standardized mortality ratio at 90 days post-admission for survival comparison.

Main Results:

  • Boys demonstrated significantly better overall survival than girls (Hazard Ratio 0.91, p=0.035).
  • The 90-day survival rate was also superior for boys (Standardized Mortality Ratio 0.85 vs. 1.02 for girls, p=0.0014).
  • This male survival advantage was most prominent in children under one year old, nonsurgical patients, and those with respiratory insufficiency or seizures, independent of cardiac conditions. No gender difference was observed in care intensity or length of stay after adjusting for morbidity.

Conclusions:

  • Boys experience better outcomes following pediatric intensive care admissions compared to girls.
  • The observed gender difference in survival is not attributable to disparities in the quality or intensity of care provided.
Abstract

Keywords:
EpidemiologyGender differencesInequalityMortalityPaediatric intensive care

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